title: Foucher first dorsal metacarpal artery flap versus littler heterodigital neurovascular flap in resurfacing thumb pulp loss defects.
abstract: Our study aims to illustrate the advantages and disadvantages of Foucher's first dorsal metacarpal artery flap and Littler's heterodigital neurovascular flap in thumb pulp reconstruction, by assessing wound healing of donor and recipient sites, sensibility, and functional outcome of the reconstructed thumb. Fourteen male patients were reconstructed either with Foucher (n = 8) or Littler flap (n = 6). Dissection of Foucher's flap was faster than that of Littler's flap. All Littler flaps survived completely, but we experienced 1 partial Foucher flap necrosis. Thumb motility and stability was optimal in all patients. Wound healing of donor sites was achieved in both groups. Two patients reconstructed with Littler flap developed scar contractures and presented a reduced range of motion of donor finger and first webspace, respectively. Although Littler flap resulted in better sensibility and tactile gnosis of the reconstructed thumb-pulp, Foucher flap ensured negligible donor site morbidity, complete cortical reorientation, and better overall hand function.
authors.affiliation: Department of Plastic Surgery, General State Hospital of Athens, Athens, Greece.
authors.forename: Iraklis P
authors.initials: IP
authors.lastname: Delikonstantinou
authors.forename: Andreas I
authors.initials: AI
authors.lastname: Gravvanis
authors.forename: Vasilios
authors.initials: V
authors.lastname: Dimitriou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Zogogiannis
authors.forename: Amalia
authors.initials: A
authors.lastname: Douma
authors.forename: Dimosthenis A
authors.initials: DA
authors.lastname: Tsoutsos
mesh_terms: D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D000368:Aged; D005385:Fingers / Q000098:blood supply / Q000294:innervation / Q000637:transplantation*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000098:blood supply / Q000637:transplantation*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult